| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $28 | 0% | $28 |
| Blood Test - Cholesterol Test, Lipid Panel | $173 | 0% | $173 |
| Blood Test - Clotting Time | $19 | 0% | $19 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $107 | 0% | $107 |
| Blood Test - Comprehensive Metabolic Panel | $137 | 0% | $137 |
| Lab Test - Detection test for Influenza Virus | $30 | 0% | $30 |
| Office Visit - Basic | $126 | 0% | $126 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $242 | 0% | $242 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $263 | 0% | $263 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $315 | 0% | $315 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $231 | 0% | $231 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $210 | 0% | $210 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $221 | 0% | $221 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $247 | 0% | $247 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $257 | 0% | $257 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $215 | 0% | $215 |
| Office Visit - Established Patient, High Complexity | $273 | 0% | $273 |
| Office Visit - Established Patient, Low Complexity | $158 | 0% | $158 |
| Office Visit - Established Patient, Moderate Complexity | $231 | 0% | $231 |
| Office Visit - New Patient, Low Complexity | $245 | 0% | $245 |
| Office Visit - New Patient, Minor | $189 | 0% | $189 |
| Office Visit - New Patient, Moderate Complexity | $349 | 0% | $349 |
| Psychiatric Diagnostic Evaluation | $263 | 0% | $263 |
| Psychotherapy - 30 Minutes | $164 | 0% | $164 |
| Psychotherapy - 45 Minutes | $184 | 0% | $184 |
| Psychotherapy - 60 Minutes | $231 | 0% | $231 |
| Psychotherapy - Group Session | $89 | 0% | $89 |
| Strep Test (Streptococcus, group A) | $44 | 0% | $44 |
| Urine Test - Automated without Microscope | $8 | 0% | $8 |
| Urine Test - Urinalysis, Manual Test | $11 | 0% | $11 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $53 | 0% | $53 |
